10 things I wish you knew about postnatal depression… in dads

It’s PNDA awareness week. This year’s theme is “I wish I knew”. So I thought I’d write a post about something that I wish people knew about PNDA.

Close your eyes and
picture someone with postnatal depression.

Though the person in
your mind might vary in lots of different ways, chances are, the person you
were picturing was a woman. Because mostly
when we think of postnatal depression, we think about mums.

But mums aren’t the only
people who can struggle with the adjustment to parenthood. Postnatal depression
can affect dads too.

Whether it is the
shift in relationship dynamics, the added financial pressure of being the sole
income, or the sleep deprivation (dads feel it too), life for a new dad can be
tough. Dads can also struggle with
feelings of guilt and inadequacy, particularly when they see their partner
having a rough time.

So here are 10 things I
wish everybody knew about postnatal depression in dads.

1. Men’s risk ofdepression doubles in the first year of being a dad.

A man’s risk of
becoming depressed in the first year of fatherhood is double that of the
general population. First time dads are
particularly vulnerable. And depression doesn’t necessarily wait until baby
arrives – one in ten dads-to-be will also become depressed during their
partner’s pregnancy.

2. We’re on this ride
together.

Postnatal depression
in dads is more likely if there is maternal postnatal depression. If one of you is having a hard time, it’s
likely that the other is too. In families where mum has a diagnosed perinatal
mental health concern, it’s estimated up to 50% of dads will also meet criteria
for a mental health concern. This isn’t
to say that a woman’s PND causes her partner’s depression. Likely you are both
experiencing many of the same psycho-social factors that contribute to BOTH of
you having a hard time.

3. Postnatal depression in men often gets missed.

The peak time for postnatal depression in men is between three and six months post birth. Unlike women who should (might) be regularlyscreened during pregnancy and postnatally, dads might not be asked how they arecoping emotionally with the transition to parenthood.

As with postnatal
depression in mums, depressive symptoms in dads often go unreported. Dads can often mistake the symptoms for the
everyday stresses of having a newborn.
There can also be a lot of stigma for men experiencing postnatal
depression, as they can feel the cultural pressure of needing to ‘hold it
together’ for their family.

Insomnia –
difficulties getting to sleep or staying asleep, increased sleep needs (feeling
tired even after a good night’s sleep)

What I politely
term “digestive distress” – aka diarrhoea or constipation

Headaches

Toothaches

Nausea

Psychological:

Feeling
fearful, confused, helpless or uncertain about the future (for a lot of men,
this may be targeted towards their work situation – wanting to quit or change
jobs, or feeling fearful about job security)

Withdrawal
from family life, work and social situations

Having
trouble making decisions

Behavioural:

Frustration,
irritability, cynicism and anger

Relationship
conflict

Partner
violence

Negative
parenting behaviours

Increased
alcohol or substance use

5. Hormonal changes affect men too.

Many people are
surprised to find out that men go through hormonal changes in the perinatal
period as well. It is thought that these hormonal changes that are designed to
help dads bond with their babies might also make postnatal depression in dads
more likely. Hormones including testosterone, oestrogen, cortisol, vasopressin,
and prolactin may change in dads during the period after their babies arrive.

6. There are a range of factors can increase the risk of postnatal depression for men.

Young dads (under 25)
are at greater risk of experiencing postnatal depression than their older dad
counterparts . Other major risk factors include: a history of depression and
anxiety; having a low income; and not being in a relationship with the child’s
mother.

Pregnancy
complications, birth trauma, or having a baby in the special care nursery or
NICU can also impact paternal adjustment.

Other factors that
make postnatal depression in men more likely include: sleeping or crying issues
with the baby; drug abuse or dependence; and feeling unsupported by their
partners. With these issues, it can be
harder to tell the direction of the relationship. Is it PND that contributes to relationship
difficulties, or is it the other way around?
Similarly, does having an unsettled baby contribute to depression, or
are babies of depressed parents more unsettled?

7. Postnataldepression contributes to relationship difficulties.

Postnatal depression
in dads can place a strain on their relationship with the baby’s. It can also
affect the relationship they have with their child.

Depressed fathers tend
to play and engage less with their children and talk more negatively about them
and to them. They are less likely to sing and read to their children, and more
likely to discipline them harshly.

8. Untreated postnatal depression in dads has consequences for their child.

Dads’ depression isassociated with emotional, social and behavioural problems as well as developmentaldelay in their children. The association is stronger when a father experiencesantenatal and postnatal depression, and when his symptoms are particularlysevere. It’s also a stronger association when the mum is also diagnosed with aperinatal mental health issue.

This isn’t about shaming dads or making them feel worse, but to highlight that it is important to get help, not just for your own wellbeing, but also the wellbeing of your children.

9. Postnatal depression in dads is treated the same as postnatal depression in mums.

The practice guidelines for treatment of postnatal depression are the same for dads as for mums. These treatments might include talking therapies with a psychologist, or management with medication. Dads also benefit from building social connections with other dads, and increasing paternal confidence through parenting programs such as circle of security can be a great addition to your parenting toolkit. Relationship counselling can also help to improve communication and re-stabilise your relationship.

10. Screening is available.

One of the tricky things about having depression and/or anxiety as a new or expecting parent is that many symptoms can look similar to what most people experience at this time: feeling tired, a bit irritable or emotional, or worrying about baby’s health. To see if what you’re experiencing or observing in a loved one could be a reason to seek help, you can fill out a short mental health checklist on the PANDA website: https://www.panda.org.au/info-support/checklists